Provider Demographics
NPI:1043305162
Name:SYNERGY REHAB CENTER LP
Entity Type:Organization
Organization Name:SYNERGY REHAB CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:N
Authorized Official - Last Name:RAJAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-554-9885
Mailing Address - Street 1:561 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE - B
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4240
Mailing Address - Country:US
Mailing Address - Phone:281-554-9885
Mailing Address - Fax:281-554-9887
Practice Address - Street 1:561 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE - B
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4240
Practice Address - Country:US
Practice Address - Phone:281-554-9885
Practice Address - Fax:281-554-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1083491261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
8T1764OtherBCBS HMO
PT1083491OtherHUMANA HMO/PPO
2165209OtherFIRST HEALTH NETWORK
TX000017KS00OtherBCBS
3291703, 7851518OtherAETNA
PT1083491OtherHUMANA HMO/PPO
TX000017KS00OtherBCBS